The COVID-19 pandemic will have dangerous, far-reaching implications long into the future, especially if it derails recent improvements in many countries’ historically weak health systems. To avoid that outcome, we urgently need to move beyond merely “protecting the needy” in times of crisis. Episodic donations are not enough. Now is the time to start removing the structural and systemic barriers that have long stood in the way of sustained improvements in global health.

Following global emergencies, the international community tends to revert to “business as usual,” rather than preparing for future disasters. With policymakers focusing solely on fighting fires, instead of addressing their underlying causes, there never seems to be a good time for prevention and mitigation.

And yet, the pandemic has demonstrated that an efficient and effective public-health response requires more than a well-functioning health-care system. It also calls for more robust “systems for health,” which comprise all the sectors that influence public health, including manufacturing, food, transportation, and urban development. While most of those working in these sectors would not readily identify as “health professionals,” they nonetheless play a pivotal role in producing good health outcomes.

The gross underfunding of health-care systems in developed and developing countries alike has created critical deficiencies that are now being exposed by the pandemic. The lack of health insurance for millions of the most vulnerable Americans posed a threat to public health long before COVID-19 arrived. Similarly, under-investment in public-health systems across Sub-Saharan Africa, South Asia, and other regions all but ensured that millions of people would be vulnerable in the event of a crisis. The pandemic has underscored the need for all societies to provide universal access to high-quality health care without the sick risking financial ruin. It shows that we can no longer turn a blind eye to the longstanding class barriers that allow only the rich to receive the best care on demand.

The pandemic also offers an opportunity to rethink how we pursue innovation and reform within failing systems. This requires that the global economic system broadens the narrow definitions of innovation to embrace (the often invisible) knowledge generated from across the global South, learning from strategies implemented in Singapore, South Korea, China, Israel, and South Africa to contain the virus and mobilize population-wide testing and contact-tracing strategies. By integrating expertise from countries that have dealt with previous deadly outbreaks of Ebola, SARS, MERS, and Lassa fever, we can develop more innovative strategies globally. Indeed, had these strategies been in place before COVID-19 spread worldwide, an effective global response to the pandemic would not have proved elusive. As the pandemic expands into countries where traditional practices are core to the notion of wellness, it will be critical to integrate these diverse knowledge systems into health-education strategies for disease prevention and treatment.

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